PMID: 24879357
Hoogeveen EK, Geleijnse JM, Kromhout D, van’t Sant P, Gemen EF, Kusters R, Giltay EJ. No effect of n-3 fatty acids supplementation on NT-proBNP after myocardial infarction: The Alpha Omega Trial. Eur J Prev Cardiol.
2015 May;22(5):648-55. doi: 10.1177/2047487314536694.
BACKGROUND: heart failure is a major risk factor for cardiovascular mortality, for which n-3 fatty acids may have beneficial effects. We examined the effect of marine eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and plant-derived alpha-linolenic acid (ALA) on N-Terminal-pro Brain Natriuretic Peptide (NT-proBNP), a biomarker of heart failure.
METHODS: we randomly assigned 4837 post-myocardial infarction patients, aged 60-80 years (82% men), to margarines supplemented with a targeted additional intake of 400 mg/day EPA and DHA, 2 g/day ALA, EPA-DHA plus ALA, or placebo for 40 months. In a random selection of 639 patients, NT-proBNP was determined both at baseline and at the end of follow-up. NT-proBNP was loge-transformed and analysed by type of treatment using analysis of covariance adjusting for baseline NT-proNBP. RESULTS: patients consumed on average 19.8 g margarine/day, providing an additional amount of 238 mg/
day EPA with 158 mg/day DHA, 1.98 g/day ALA, or both, in the active-treatment groups. In the placebo group, the geometric mean level NT-proBNP increased from 245 ng/l (95%-confidence interval [CI]: 207-290) to 294 ng/l (95%-CI: 244-352) af-ter 40 months (p = 0.001). NT-proBNP levels were not affected by ALA (+8% versus placebo; 95%-CI: -8% to +25%; p = 0.34), EPA-DHA (+2% versus placebo; 95%-CI: -14% to +18%; p = 0.78), nor EPA-DHA plus ALA (+9% versus placebo; 95%-CI: -8%
to +25%; p = 0.31) treatment. CONCLUSIONS: supplementation with modest amounts of EPA-DHA, with or without ALA, did not have a significant effect on NT-proBNP levels in patients with a history of myocardial infarction. TRIAL REGISTRATION:
ClinicalTrials.gov NCT00127452.
PMID: 25311511
Kubat BB, Buiskool MM, van Suylen RJ. Traumatic vertebral artery injury: proposal for classification of the severity of trauma and likelihood of fatal outcome. Int J Legal Med. 2015 Jan;129(1):141-8. doi: 10.1007/
s00414-014-1095-9.
Vertebral artery injury (VAI) occurs after (blunt) trauma as well as spontaneously. The risk of incurring VAI from a blunt trauma probably parallels the severity of trauma, often referred to as major- and minor-trauma. However, the literature does not provide concrete definitions of these terms. This study aims to define minor- and major-trauma and to analyze the
likelihood of fatal outcome in VAI. For this purpose, classification criteria of major- and minor-trauma were developed and a PubMed database search was performed for articles on VAI published prior to 2013. The definitions of minor- and major-trauma, derived mainly from radiological screening criteria in cervical spine injury and based on the mechanism leading to the injury, were used in the analysis of the literature. The search produced 241 VAI cases with sufficiently detailed data for the comparison of major-trauma (52 cases, 50 lethal), minor-trauma (8 cases, none lethal), and no-trauma (182 cases, 69 lethal). The numbers of lethal cases in the total study population and subgroups differed significantly between the groups (Fisher’s exact test) and the likelihood ratios (LRs) of lethal outcome were substantially higher in the major-trauma group compared to the other groups. The highly significant p values show that the proposed criteria differentiate between trauma types with regard to fatal outcome. The presented results can assist in the evaluation of forensic cases of VAI.
PMID: 25425692
Zwaginga JJ, van der Holt B, Te Boekhorst PA, Biemond BJ, Levin MD, van der Griend R, Brand A, Zweegman S, Pruijt HF, Novotny VM, Vreugdenhil A, de Groot MR, de Weerdt O, van Pampus EC, van Maanen-Lamme TM, Wittebol S, Schipperus MR, Silbermann MH, Huijgens PC, Luten M, Hollestein R, Brakenhoff JA, Schrama JG, Valster FA, Velders GA, Koene HR; Dutch HOVON 64 study group. Multi-center randomized open label phase II trial on three rituximab dosing schemes in immune thrombocytopenia patients. Haematologica. 2015 Mar;100(3):e90-2. doi: 10.3324/haematol.2014.110213. No abstract available.
PMID:25430660
Prinsen JH, Boersma D, van Loenhout R, van Schaik PM, Verhoeven BA. Persistent endoleak after endovascular aneurysm repair for acute Q-fever-infected aortocaval fistula. Vascular. 2015;23:645-7
We present a case of an endovascular aneurysm repair for a Q-fever-infected acute abdominal aortic aneurysm with aorto-caval fistula. Type 2 endoleak persisted after successful endovascular repair.
PMID: 25443772
Wouters E, Wojciechowski M, de Vries E. Two cases of rickets presenting with poor growth, hypotonia, and respiratory problems. Acta Clin Belg. 2015 Jun;70(3):211-4. doi: 10.1179/2295333714Y.0000000103.
Rickets is a rare disease in developed countries. In children, it is a disease which affects growing bone. Depending on the severity, it can present with a wide variety of symptoms. Because it is such a rare disease in developed countries, symptoms suggesting rickets are often not easily recognized. This can cause a delay in diagnosing and treating rickets. Often unneces-sary and sometimes invasive investigations are performed. First leading clues to rickets on physical examination are poor growth, especially length, thickening of wrists, bow legs, and craniotabes. At further examination, special attention should be paid to osteopenia and cupping and fraying at the metaphyses on X-rays. Laboratory results suggestive for rickets are elevated alkaline phosphatase and disturbances in calcium and phosphate homeostasis. In this report, we present two cases presenting with poor growth, severe pain, and respiratory problems secondary to calcipenic rickets.
PMID: 25452219
Boellaard R, Delgado-Bolton R, Oyen WJ, Giammarile F, Tatsch K, Eschner W, Verzijlbergen FJ, Barrington SF, Pike LC, Weber WA, Stroobants S, Delbeke D, Donohoe KJ, Holbrook S, Graham MM, Testanera G, Hoekstra OS, Zijlstra J, Visser E, Hoekstra CJ, Pruim J, Willemsen A, Arends B, Kotzerke J, Bockisch A, Beyer T, Chiti A, Krause BJ. FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0. Eur J Nucl Med Mol Imaging. 2015 Feb;42(2):328-54.
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The purpose of these guidelines is to assist physicians in recommending, performing, interpreting and reporting the results of FDG PET/CT for oncological imaging of adult patients. PET is a quantitative imaging technique and therefore requires a common quality control (QC)/quality assurance (QA) procedure to maintain the accuracy and precision of quantitation. Re-peatability and reproducibility are two essential requirements for any quantitative measurement and/or imaging biomarker.
Repeatability relates to the uncertainty in obtaining the same result in the same patient when he or she is examined more than once on the same system. However, imaging biomarkers should also have adequate reproducibility, i.e. the ability to yield the same result in the same patient when that patient is examined on different systems and at different imaging sites.
Adequate repeatability and reproducibility are essential for the clinical management of patients and the use of FDG PET/
CT within multicentre trials. A common standardised imaging procedure will help promote the appropriate use of FDG PET/
CT imaging and increase the value of publications and, therefore, their contribution to evidence-based medicine. Moreover, consistency in numerical values between platforms and institutes that acquire the data will potentially enhance the role of semiquantitative and quantitative image interpretation. Precision and accuracy are additionally important as FDG PET/CT is used to evaluate tumour response as well as for diagnosis, prognosis and staging. Therefore both the previous and these new guidelines specifically aim to achieve standardised uptake value harmonisation in multicentre settings.
PMID: 25511908
Ahmed Ali U, Issa Y, van Goor H, van Eijck CH, Nieuwenhuijs VB, Keulemans Y, Fockens P, Busch OR, Drenth JP, Dejong CH, van Dullemen HM, van Hooft JE, Siersema PD, Spanier BW, Poley JW, Poen AC, Timmer R, Seerden T, Tan AC, Thijs WJ, Witteman BJ, Romkens TE, Roeterdink AJ, Gooszen HG, van Santvoort HC, Bruno MJ, Boermeester MA; Dutch Pancreatitis Study Group. Dutch Chronic Pancreatitis Registry (CARE): design and rationale of a nationwide prospective evaluation and follow-up. Pancreatology. 2015 Jan-Feb;15(1):46-52. doi:
10.1016/j.pan.2014.11.002. Epub 2014 Nov 29.
BACKGROUND: Chronic pancreatitis is a complex disease with many unanswered questions regarding the natural history and therapy. Prospective longitudinal studies with long-term follow-up are warranted. METHODS: The Dutch Chronic Pancreatitis Registry (CARE) is a nationwide registry aimed at prospective evaluation and follow-up of patients with chronic pancreatitis. All patients with (suspected) chronic or recurrent pancreatitis are eligible for CARE. Patients are followed-up by yearly questionnaires and review of medical records. Study outcomes are pain, disease complications, quality of life, and pancreatic function. The target sample size was set at 500 for the first year and 1000 patients within 3 years. RESULTS: A total of 1218 patients were included from February 2010 until June 2013 by 76 participating surgeons and gastroentero-logist from 33 hospitals. Participation rate was 90% of eligible patients. Eight academic centers included 761 (62%) patients, while 25 community hospitals included 457 (38%). Patient centered outcomes were assessed by yearly questionnaires, which had a response rate of 85 and 82% for year 1 and 2, respectively. The median age of patients was 58 years, 814 (67%) were male, and 38% had symptoms for less than 5 years. DISCUSSION: The CARE registry has successfully recruited over 1200 patients with chronic and recurrent pancreatitis in about 3 years. The defined inclusion criteria ensure patients are included at an early disease stage. Participation and compliance rates are high. CARE offers a unique opportunity with sufficient power to investigate many clinical questions regarding natural course, complications, and efficacy and timing of treatment strategies.
PMID: 25527569
Van der Velden WJ, Nissen L, van Rijn M, Rijntjes J, de Haan A, Venkatraman L, Catherwood M, Liu H, El-Daly H,
van de Laar L, Craenmehr MH, van Krieken JH, Stevens WB, Groenen PJ. Identification of IG-clonality status as a
pre-treatment predictor for mortality in patients with immunodeficiency-associated Epstein-Barr virus-related
lymphoproliferative disorders. Haematologica. 2015 Apr;100(4):e152-4. doi: 10.3324/haematol.2014.116780.
PMID: 25537564
Johannesma PC, Reinhard R, Kon Y, Sriram JD, Smit HJ, van Moorselaar RJ, Menko FH, Postmus PE; Amsterdam BHD working group. Prevalence of Birt-Hogg-Dubé syndrome in patients with apparently primary spontaneous pneumothorax. Eur Respir J. 2015 Apr;45(4):1191-4.
PMID: 25556708
Keijsers CJ, Segers WS, de Wildt DJ, Brouwers JR, Keijsers L, Jansen PA. Implementation of the WHO-6-step method in the medical curriculum to improve pharmacology knowledge and pharmacotherapy skills.
Br J Clin Pharmacol. 2015 Jun;79(6):896-906. doi: 10.1111/bcp.12575.
AIM: The only validated tool for pharmacotherapy education for medical students is the 6-step method of the World Health Organization. It has proven effective in experimental studies with short term interventions. The generalizability of this effect after implementation in a contextual-rich medical curriculum was investigated. METHODS: The pharmacology knowledge and pharmacotherapy skills of cohorts of students, from years before, during and after implementation of a WHO-6-step-based integrated learning programme were tested using a standardized assessment containing 50 items covering know-ledge of basic (n = 25) and clinical (n = 24) pharmacology, and pharmacotherapy skills (n = 1 open question). All scores are expressed as a percentage of the maximum score possible per (sub)domain. RESULTS: In total, 1652 students were included between September 2010 and July 2014 (participation rate 89%). The WHO-6-step-based learning programme improved students’ knowledge of basic pharmacology (mean score ± SD, 60.6 ± 10.5% vs. 63.4 ± 10.9%, P < 0.01) and clinical or ap-plied pharmacology (63.7 ± 10.4% vs. 67.4 ± 10.3%, P < 0.01), and improved their pharmacotherapy skills (68.8 ± 26.1% vs.
74.6% ± 22.9%, P 0.02). Moreover, satisfaction with education increased (5.7 ± 1.3 vs. 6.3 ± 1.0 on a 10-point scale, P < 0.01) and as did students’ confidence in daily practice (from -0.81 ± 0.72 to -0.50 ± 0.79 on a -2 to +2 scale, P < 0.01). CONCLU-SIONS: The WHO-6-step method was successfully implemented in a medical curriculum. In this observational study, the integrated learning programme had positive effects on students’ knowledge of basic and applied pharmacology, improved their pharmacotherapy skills, and increased satisfaction with education and self-confidence in prescribing. Whether this training method leads to better patient care remains to be established.
PMID: 25563783
Van Roosmalen J, van der Linden Y, Bod-Jaspers J. A man with a raised upper arm. Ned Tijdschr Geneeskd.
2015;159(0):A8279. Dutch.
A 43-year-old man presented at our emergency department with a painful shoulder after a fall with his arm in abduction.
Clinical presentation was typical for a luxatio erecta without evidence for neurovasculair damage. It is a rare but important diagnosis because of the high risk of plexus injury.
PMID:25563786
Kuipers BC, Jansen EJ, van Mil EG. Een neonaat met een interlabiale cyste. [A neonate with an interlabial cyst].
[Article in Dutch]. Ned Tijdschr Geneeskd. 2015;159:A8355.
During a routine physical examination of a term, healthy neonate of Somalian origin we observed an anteriorly located interlabial yellow cyst with visible vascularisation on the outer surface. It caused lateralisation of the urinary meatus without notable obstruction. A Skene’s duct cyst, or paraurethral cyst, was clinically diagnosed with spontaneous regression. This is a self-limiting phenomenon of unknown origin that rarely requires surgical drainage in case of urinary obstruction.
131 BIJLAGE WETENSCHAPPELIJKE PUBLICATIES 2013-2014 OPGENOMEN IN PUBMED
PMID: 25563886
Goos JA, de Cuba EM, Coupé VM, Diosdado B, Delis-Van Diemen PM, Karga C, Beliën JA, Menke-Van der Houven van Oordt CW, Geldof AA, Meijer GA, Hoekstra OS, Fijneman RJ; DeCoDe PET Group. Collaborators: van Grieken NC, Perk LR, van den Tol MP, te Velde EA, Windhorst AD, Baas J, Rijken AM, van Beek MW, Pijpers HJ, Bril H, Stockmann HB, Zwijnenburg A, Bosscha K, van den Brule AJ, Hoekstra CJ, van der Linden JC, Rinkes IH, van Diest PJ, van Hillegersberg R, Kranenburg O, Lam MG, Snoeren N, Liem IH, Roumen RM, Vening W. Glucose Transporter 1 (SLC2A1) and Vascular Endothelial Growth Factor A (VEGFA)Predict Survival After Resection of Colorectal Cancer Liver Metastasis. Ann Surg. 2016 Jan;263(1):138-45.
OBJECTIVE: To investigate the individual and combined prognostic value of HIF1κ, SLC2A1, and vascular endothelial growth factor A (VEGFA) in a multi-institutional cohort of patients with resected colorectal cancer liver metastasis (CRCLM).
BACKGROUND: In the majority of patients with CRCLM, resection seems not to be curative, despite its curative intent.
Overexpression of hypoxia-inducible factor 1κ (HIF1κ), glucose transporter 1 (SLC2A1; also known as GLUT1), and VEGFA has been associated with tumor progression and poor prognosis of patients with colorectal cancer (CRC). METHODS: Tissue microarrays were generated using CRCLM and patient-matched primary CRC from patients who underwent CRCLM resec-tion between 1990 and 2010. Prognostic value of HIF1κ, SLC2A1, and VEGFA was determined by immunohistochemistry. A 500-fold cross-validated hazard rate ratio (HRRav) for overall survival was calculated. RESULTS: HIF1κ, SLC2A1, and VEGFA expression could be evaluated in 328, 350, and 335 patients, respectively. High SLC2A1 expression was associated with good prognosis (HRRav, 0.67; P (HRR >1) < 0.01) and high VEGFA expression to poor prognosis (HRRav, 1.84; P (HRR < 1) = 0.02), also after multivariate analysis including established clinicopathological prognostic variables (HRRav, 0.67; P (HRR >
1) < 0.01 and HRRav, 1.50; P (HRR < 1) = 0.02, respectively). SLC2A1 showed prognostic value particularly in patients trea-ted with systemic therapy (P < 0.01), whereas the prognostic value of VEGFA expression was mainly observed in patients not treated with systemic therapy (P < 0.01). Prognosis was especially poor in patients with both low SLC2A1 and high VEGFA expression (P < 0.01). HIF1κ expression was not associated with survival. CONCLUSIONS: SLC2A1 and VEGFA expression are prognostic molecular biomarkers for patients with CRCLM with added value to established clinicopathological variables.
PMID: 25572007
Aarts MJ, Aerts JG, Van den Borne BE, Biesma B, Lemmens VE, Kloover JS. Comorbidity in patients with small cell lung cancer: trends and prognostic impact. Clin Lung Cancer. 16(4):282-91, 2015. doi: 10.1016/j.
cllc.2014.12.003.
INTRODUCTION: We evaluated the trends in the prevalence of comorbidity and its prognostic impact in a cohort of un-selected patients with small-cell lung cancer (SCLC). PATIENTS AND METHODS: All patients (n = 4142) diagnosed with SCLC from 1995 to 2012 were identified from the population-based Netherlands Cancer Registry in the Eindhoven region.
RESULTS: The prevalence of comorbidity increased from 55% in 1995 to 1998 to 76% in 2011 to 2012 and multimorbi-dity (ie, ≥ 2 concomitant diseases) from 23% to 51%. The prevalence of a comorbimultimorbi-dity increased with age. Among the men, hypertension, cardiac disease, and diabetes, in particular, became more common (increased from 11% to 35%, from 19% to 36%, and from 7% to 18%, respectively). In the women, the rate of pulmonary disease, hypertension, and cardiac disease increased the most (increased from 18% to 30%, from 12% to 28%, and from 11% to 24%, respectively). Multimorbidity was associated with a slightly increased hazard of death, independent of treatment in those with limited-stage SCLC (hazard ratio [HR] for ≥ 2 comorbidities vs. no comorbidities, 1.2; 95% confidence interval [CI], 1.0-1.4). The prognostic effects of multimorbidity resulted from treatment in those with extensive-stage SCLC (HR for ≥ 2 comorbidities vs. no comorbidities, final model, 1.2; 95% CI, 1.0-1.2). The prognostic impact of the specific comorbidities varied, with digestive disease reducing the hazard and cardiac disease increasing the hazard in those with limited-stage SCLC (HR for digestive disease vs. no digestive disease, 0.7 [95% CI, 0.5-0.9], and HR for cardiac vs. no cardiac disease, 1.2 [95% CI, 1.0-1.3]). Also, cardiac and
cerebrovascular disease increased the hazard in those with extensive-stage SCLC (HR 1.2 [95% CI, 1.0-1.3] and HR 1.3 [95%
CI, 1.1-1.6], respectively). CONCLUSION: Comorbidity among patients with SCLC is very common and has been increasing.
Multimorbidity was associated with a slightly increased hazard of death in those with limited-stage SCLC, independent of treatment. However, the prognostic effects in those with advanced-stage SCLC resulted from treatment. Digestive disease favorably affected survival and cardiac disease negatively affected the prognosis for those with limited-stage SCLC, and cardiac and cerebrovascular diseases had a negative prognostic effect for those with extensive-stage SCLC. With the burden of comorbidities in patients with SCLC increasing, more attention to individualized treatment approaches is needed.
PMID: 25576320
Bensdorp AJ, Tjon-Kon-Fat RI, Bossuyt PM, Koks CA, Oosterhuis GJ, Hoek A, Hompes PG, Broekmans FJ, Verhoeve HR, de Bruin JP, van Golde R, Repping S, Cohlen BJ, Lambers MD, van Bommel PF, Slappendel E, Perquin D, Smeenk JM, Pelinck MJ, Gianotten J, Hoozemans DA, Maas JW, Eijkemans MJ, van der Veen F, Mol BW, van Wely M. Prevention of multiple pregnancies in couples with unexplained or mild male subfertility: randomised controlled trial of in vitro fertilisation with single embryo transfer or in vitro fertilisation in modified natural cycle compared with intrauterine insemination with controlled ovarian hyperstimulation.
BMJ. 2015 Jan 9;350:g7771. doi: 10.1136/bmj.g7771.
OBJECTIVES: To compare the effectiveness of in vitro fertilisation with single embryo transfer or in vitro fertilisation in a modified natural cycle with that of intrauterine insemination with controlled ovarian hyperstimulation in terms of a healthy child. DESIGN: Multicentre, open label, three arm, parallel group, randomised controlled non-inferiority trial. SETTING:
17 centres in the Netherlands. PARTICIPANTS: Couples seeking fertility treatment after at least 12 months of unprotected intercourse, with the female partner aged between 18 and 38 years, an unfavourable prognosis for natural conception, and a diagnosis of unexplained or mild male subfertility. INTERVENTIONS: Three cycles of in vitro fertilisation with single embryo transfer (plus subsequent cryocycles), six cycles of in vitro fertilisation in a modified natural cycle, or six cycles of intrauterine insemination with ovarian hyperstimulation within 12 months after randomisation. MAIN OUTCOME MEASURES: The pri-mary outcome was birth of a healthy child resulting from a singleton pregnancy conceived within 12 months after randomi-sation. Secondary outcomes were live birth, clinical pregnancy, ongoing pregnancy, multiple pregnancy, time to pregnancy, complications of pregnancy, and neonatal morbidity and mortality. RESULTS: 602 couples were randomly assigned between January 2009 and February 2012; 201 were allocated to in vitro fertilisation with single embryo transfer, 194 to in vitro fertilisation in a modified natural cycle, and 207 to intrauterine insemination with controlled ovarian hyperstimulation. Birth of a healthy child occurred in 104 (52%) couples in the in vitro fertilisation with single embryo transfer group, 83 (43%) in the in vitro fertilisation in a modified natural cycle group, and 97 (47%) in the intrauterine insemination with controlled ovarian hyperstimulation group. This corresponds to a risk, relative to intrauterine insemination with ovarian hyperstimulation, of 1.10 (95% confidence interval 0.91 to 1.34) for in vitro fertilisation with single embryo transfer and 0.91 (0.73 to 1.14) for in vitro fertilisation in a modified natural cycle. These 95% confidence intervals do not extend below the predefined threshold of 0.69 for inferiority. Multiple pregnancy rates per ongoing pregnancy were 6% (7/121) after in vitro fertilisation with single embryo transfer, 5% (5/102) after in vitro fertilisation in a modified natural cycle, and 7% (8/119) after intrauterine insemination with ovarian hyperstimulation (one sided P=0.52 for in vitro fertilisation with single embryo transfer compared with intrauterine insemination with ovarian hyperstimulation; one sided P=0.33 for in vitro fertilisation in a modified natural cycle compared with intrauterine insemination with controlled ovarian hyperstimulation). CONCLUSIONS: In vitro fertilisation with single embryo transfer and in vitro fertilisation in a modified natural cycle were non-inferior to intrauterine insemina-tion with controlled ovarian hyperstimulainsemina-tion in terms of the birth of a healthy child and showed comparable, low multiple pregnancy rates.Trial registration Current Controlled Trials ISRCTN52843371; Nederlands Trial Register NTR939.
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PMID: 25577174
Wielders CC, Hackert VH, Schimmer B, Hodemaekers HM, de Klerk A, Hoebe CJ, Schneeberger PM, van Duynhoven YT, Janssen R. Single nucleotide polymorphisms in immune response genes in acute Q fever cases with differences in self-reported symptoms. Eur J Clin Microbiol Infect Dis. 2015 May;34(5):943-50. doi:
10.1007/s10096-014-2310-9. Epub 2015 Jan 11.
Genes involved in human immune response are well recognized to influence the clinical course of infection. The association of host genetics with susceptibility to and severity of clinical symptoms in acute Q fever was investigated. Single nucleotide
Genes involved in human immune response are well recognized to influence the clinical course of infection. The association of host genetics with susceptibility to and severity of clinical symptoms in acute Q fever was investigated. Single nucleotide